Borisy says that the company is focusing on bringing together four areas of expertise: genomic sequencing and analysis, cancer biology, clinical oncology, and information science. The first challenge is to translate genomics research tools into a clinically useful and reliable test. The company will then need to verify the utility and cost effectiveness of such a test in a real-world clinical setting. Another challenge will be to provide clinicians with straightforward information about how to interpret the results and act on them.
Foundation Medicine’s founding scientific advisors are Eric Lander, head of the Broad Institute, a genomics research center in Cambridge, MA and three leading figures in cancer genomics at the Broad and Harvard Medical School: Todd Golub, Matthew Meyerson, and Levi Garraway. Myerson says that the company’s approach will harness the power of advanced genomic sequencing to give clinicians accurate information about a patient’s cancer. “A relatively comprehensive picture of the cancer genome is probably the best way to get a good understanding of what is the right diagnostic and the right treatment for the patient,” he says.
Myerson also believes it makes sense to act now, even though the ability to target decision-making to specific genetic alterations is still in its infancy. Borisy points out that in a few years the federally funded Cancer Genome Atlas Project will have sequenced tens of thousands of cancer genomes, several thousand for each type of cancer. The company is banking on the fact that these efforts will yield usable information that can to be translated to clinical practice.
“The idea is fabulous,” says Gerold Bepler, CEO of the Karmanos Cancer Institute, in Detroit. “I think that in the future this will really revolutionize the way we treat patients.” The question, he says, is whether this concept is truly actionable right now. For example, one of the technical hurdles that stands in the way of bringing cancer genomics to patient care is the way cancer samples are made. Most research studies involve fresh frozen samples that are much easier to glean information from; clinical samples are typically chemically fixed and embedded in paraffin, which can alter the chemical state of the cells. These samples may also have a relatively low level of cancer cells to work from. So getting accurate information from real-world clinical samples will be a significant challenge, particularly if the company wants to expand its analysis to the chemistry of cancers.